Celiac Disease

(Celiac Sprue; Nontropical Sprue; Gluten-Sensitive Enteropathy)

Definition

Celiac disease is an autoimmune disease of the digestive tract. In celiac disease, eating food with gluten damages little bulges in the small intestine. These bulges, called villi, absorb nutrients from foods. The condition affects the absorption of all nutrients. Untreated patients often become malnourished.

Causes

Doctors do not fully understand what causes celiac disease. Eating gluten seems to be involved. There is most likely a genetic factor. Patients with specific genes develop the disease after exposure to gluten. There is some evidence that earlier exposure in infancy can cause a more severe disease than later exposure.

Symptoms

Symptoms vary and may start in childhood or adulthood. Children often have different symptoms than adults. Symptoms may not develop if a large section of the intestine is undamaged. Malnutrition may produce the first signs of the condition, which are often the most serious.

Diagnosis

Images may be taken of your body intestines. This can be done with endoscopy.

Treatment

A life-long,
gluten-free diet
is the only treatment for celiac disease. It is very effective. Symptoms usually go away within days of starting the diet. However, healing of the villi may take months or years. Additional intake of gluten can damage the intestines, even if you have no symptoms. Delayed growth and tooth discoloration may be permanent. Nutritional supplements, given through a vein, may be needed if the intestinal damage does not heal. Since gluten is added to many foods, the diet can be complicated and often frustrating. Some patients find support groups helpful.

Dietary Changes

You must avoid all foods containing:

Wheat

Rye

Barley

This includes most bread, pasta, cereal, and processed foods. Special gluten-free breads and pastas are available. They are made with potato, rice, soy, or bean flour. A dietitian can assist you with meal planning.

Gluten is found in some unexpected foods and beverages. Carefully read all labels. Other foods with gluten include:

Flavored coffee

Beer

Tuna in vegetable broth

Packaged rice mixes

Some frozen potatoes

Creamed vegetables

Commercially prepared vegetables, salads, and salad dressings

Pudding

Some ice cream

Many other products

Ordering at restaurants can be especially challenging, since many foods on the menu may contain gluten.

Screening and Supplements

Patients with celiac disease should be tested to make sure they are getting enough nutrients.
Bone density testing
may also be needed. If you lack vitamins or minerals, the doctor may advise taking supplements. However, once the disease is under control with a gluten-free diet, this is often not necessary.

Prevention

There are no guidelines for preventing celiac disease because the cause is not understood. If celiac disease runs in your family, ask your doctor about a screening test. The earlier you start the gluten-free diet, the less damage there will be to the intestine.

What I need to know about Celiac disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/celiac%5Fez/. Updated September 11, 2013. Accessed December 18, 2014.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.